Response to faces may help predict social skills of autistic people

Researchers from England, France, Germany, the Netherlands and Italy propose a method to subdivide people with ASD (autism spectrum disorder). In a study published last Wednesday (17) in the scientific journal Science Translational Medicine, the group suggests that assessing the way the brain reacts to faces can help predict the development of social skills and differentiate groups of patients.

Currently, the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), a document of the American Psychiatric Association used as a standard by health professionals, divides ASD into three levels of severity, according to communication skills and standards. of behavior. The researchers want to go further and offer a classification that helps predict the prognosis.

“Our ability to predict how skills will develop in an autistic person is very limited. The subdivision presented in the DSM reflects current care needs, so it has good clinical utility for determining how the person is doing at the time of assessment. However, these levels do not indicate how your abilities and difficulties will change over time”, says Emily Jones, a researcher at the University of London and one of the authors of the work.

“In our study we tried to find prognostic markers, signs that can help predict how the person is likely to be in the future. This can help in treatment planning”, he adds.

One in 160 children has autism spectrum disorder, according to PAHO (Pan American Health Organization), while the American CDC (Center for Disease Control and Prevention) estimates one in 44. In Brazil, the total number of cases in population will be known after analyzing the 2022 Census data, as for the first time the IBGE includes a question about the disorder in the questionnaire.

According to the Ministry of Health, it is a disorder characterized by atypical development, behavioral manifestations, deficits in communication and social interaction, as well as repetitive and stereotyped behavior patterns.

These characteristics, however, vary among patients. While some can live independently, others need care, hence the importance of stratifying the set into more homogeneous subgroups — something the researchers suggest doing from the neural response to faces.

Scientists evaluated how people’s brains reacted to being exposed to pictures of faces. Data from 436 participants between 6 and 31 years old were used, 246 with autism and 190 without the disorder.

Using electroencephalograms, they measured and compared N170, the peak of electrical activity that indicates the brain’s response to visual stimuli. As previous studies indicated, they found that the response time of people with autism spectrum disorder is longer, that is, they have slower reactions when exposed to faces.

The group then matched these results to MRI measurements, genetic risk scores, and behavior scale applications. Latency in N170 has been observed to be associated with different patterns of activation of a region of the brain called the fusiform gyrus and a higher polygenic risk for autism spectrum disorder.

The scientists also noted that variation in response to faces is associated with different scores on a test that analyzes socialization, allowing them to identify a subgroup with slower social responses and poor social prognosis that could benefit from differentiated care strategies.

“We found that a specific brain marker, N170, which reflects how quickly the brain responds to faces, was linked to changes in everyday social skills over 12 to 18 months,” says Jones. “We further found that this relationship was particularly strong in a subgroup of autistic people who had a particular pattern of brain responses to faces.”

According to Jones, this response could be used as part of an assessment to provide the individual with more information about how their everyday social skills may naturally change over time and for them to decide whether they want to engage in interventions designed to help with everyday social dynamics.

The researchers argue that N170 meets basic criteria for consideration as a stratifying factor for the disorder. They point out, however, that more research is needed to reinforce this understanding and to apply measurement in a classification that allows for targeted care strategies.

“We need to confirm the results in other samples and work to understand why differences in this marker are related to social behavior”, says the researcher. “Ultimately, we need to work with autistic people to devise better ways to measure their ‘outcomes’ and ensure that what we’re measuring is important to the community.”